HomeMy WebLinkAbout30136870 - Permit (2)City of Santa Ana 20 Civic Center Plaza (M-19), Santa Ana, CA 92702 PIu
permit counter: (714) 647-5800 tnspection Requests: 1ttDl Aeffitnspector Section: (714) 647-5853
mbing Permit #: 3O136870
Pin #: 64049
Project Address: 3705 S Ross St
Assessor's Parcel: 410-142-15 Lot 18
Unit:
Block:NA
Bldg:
Tract 6702
Address Range:
Historic: No
Suite Range:
Zoning: R1
Owner:
Address:
BEN HUANG
3705 S ROSS ST
Santa Ana, CA 92707
(949) 378-6972
Fee Type Amount
01116002 51602 Wtr Htr (Res up to 50 gi 20.73
01116002 51600 General Plan Update 20.56
01116002 51602 lssuance 51.26
Qty
1.00
1.00
1.00
Fee
$20.73
$20.56
$51.26Phone
Tenant Name:
Contractor:
Address:
Fast Water Heater Company
11715 North Creek Pkwy So
Bothell, WA 98011
(425) 636-7084Phone
State Lic #: 987398
Lic Type: C-36
Bus. Lic #: 319396
Workers' Compensation lnsurance:Carrier: Liberty Mutual
Policy #: WC2291464563025
Expires: 1210112016
Building Use:
Job Type:
Nature of Work:
Single Family Dwelling
Miscellaneous
Plumbing
Occupancy:
Constr Type:
Code:
R-3
VB
cPc 2013 Notes: Plumbing
Planning Conditions:
Planning Approval By:
Plan Checked By:
Permit lssued By:
Subject to Field:
Building Permit #:
web_user
Date:
Date:
Date:07t0112016
Account#
Misc. Receipt:
Misc. Receipt:
Misc. Receipt:
Total
Every permit issued shall become invalid unless the work on the site
authorized by such permit is commenced within 180 days after its
issuance, or if the work authorized on the site by such permit ls suspended
or abandoned for a period of 1 80 days after the time the work is
commenced.
Fee Total:
Paid to Date:
Balance Due:
$92.5s
$92.55
$0.00
lnspector MID#: 2016-129819
N/A - No Balance
PLUMBING.!NSPECTOR RECORD
APPROVALS DATE ID/SIG.COMMENTS O\I'NER BUII.DT:R D}:I,CARA'I'ION
I hocby affm undc pmalty of po'jury tha! I u cxmpt from thc ContrsctoE' Licme lrw for thc following reen (56.7031.5
Buinas md Profcsaion Codc)r Any City or County which rcquirc a pcrmit to construct, alto, improvc. dmolish or rcpair ay
stsuctuc, prbr to its issumcc, also rcquiro thc applicut for such pcrmit to filc a signcd statmmt thal hc or she b licdscd pwmt
to thc prcvisioE of thc Contraclor's Liccmcd law (Chapts 9. Comcncing whh Scction 7000 of Division 3 of the Bsins md
PrcfcssionsCodc)orthathcorshciscrcmptthqefrommdth.bsisforthcallcgcdcrmption. AnyviolationofScclionT0Sl,5byany
applicantforapdmitsubjetsthc applicanttoacivilpmaltyofootmorethufivchundrcddollus($500).
-1,
a owtrs of thc prcpcrty. or my mploy€ wilh wag6 6 thcir rclc compruation. will do thc work ad thc structuc is not
intadcd or offccd for slc (Sc.7044. Buine od hofesiom Codc: Thc Contractor's Licos Law do6 not apply to m om6 of
thc propqty who builds or improvc th@rl ed who doB such wo* himself or hmclf or thrcugh his or ho om cmployce.
providc{ that such improvqmts e rct intqrdcd or ofnrcd for eb. I[, holffi. thc boilding or impovmt is pld within onc ]q
of@mpLtiolr thc O*ntr Buildq will havc thc hulen ofpoving tha he or shc did not build or imprcvc thc prcpsty for thc purpos of
sh).
-1,
rownq of thc prcpqty, @ cxclBivcly contractirg with liccNcd coftractoE to construct thc prcjcct (Ss. 7044, Buins
dd Ptoftsir Codc: Thc Contrrtor's Licosc Law do6 not apply to e ownr of propcrty who buil& or irnprcvB thq@n,
ud who contracls for such projcts with a Contraclo(s) lic$cd puE@t to thc Contraclor's Licw larv).
-l
m cxopt utrdq Satioo-. B. & P.C. forthis ren.
Dxte:()wner:
WORKERS'COMPENSATTON
DECI-I\RATION
I hocby affm undo paralty ofpajury onc ofthc following delaratiom:
-l
havc and will ruintain a Cdificatc of CoMt to Sclflmuc for work6' comJmsalion. r povidcd for by Sction 3700 of thc
Labor Codc, for thc pqfomilcc of thc wort for which thc pamit is i$ucd.
-l
havc and will maintain work6' compeNatiotr iNuancc, 6 rcquired by Setion 3700 of thc l-abor Code. for thc pqfollrucc of
thc work for which this pcnnit is i$ucd My workc' compcn$tion imurmcc cmia urd policy numba rc:
Policy Numbo: Erpires:
-l
cdliry lhal in the pqformnce of the work for which this psmit is issued. I shall not mploy my p€mn in any mona
rc atobecomcsubjcttothcworkm'compmationlawrofcalifomia,andagrcthaiflshouldbecomesubjcttothc
wortm' compcrwtion provisioro of Selion 3700 of lhc txbor Codc, I sh8ll. forthwith comply with thor prcvisiom..
WARNING: Failurc to wuc workm'composation cov@gc is unlawful, md shall subjcct an mploy6 to qiminal pcnaltic md
civil fine up to one hundrd thousqnd dollm ($100.000), in addition to lhc cosl of compcmtion, damagc u providcd for thc
Setion 3076 of thc Lsbo Codc, intsBt ud artomcy's fc6.
LICENSEN CONTRACTOR
DECI.ARATION
I hcby alfm unda panalty of pcrjury that I m ticas.d udq lrovision of Chaptq 9 (com@cir8 with Setion 7000) of Divisior 3
of thc Buiae md Profciom Codc, ard ny lic@ is in full forcc md cffcrt.
Lodq's Addrs:
APPLICANT DECLARATION
I hq$y aftrn uodq psralty of pajury ooc of thc following deloations:
Doolitiotr Pmits-Asbclos Notification Fedtral Rcgulatiotrs (Titlc 40, Pan6)
-Rcquircd
Ldt6 of Notificaliotr
_I cgriry thd thc lbdcEl rcgulatioro rcgrding rbatos roovaluc not applicablc to this prcjet.
-l
cdiry thd I hEvc rad this application ed statc that thc sbovc information is corecl. I agre to comply with all City and Couty
ordinmcB ed Statc kws rclatiDg to buildiog coBtsuclio& and hrcby authorirc repr6otdivB of thb Chy md Couty to otq upo! ttrc
abovr m@tioncd prcpcny for iropetion pupos.
Appllcrn( or Agst
I'crmitcc trf,ilrc
I)ale:
UNDER GROUND
Waste & Vent
Water-Under floor
Gas-Underfloor
Buildinq Sewer
Area/Storm Drain
I nterceptor/ Cla rif ier
TOP OUT
Waste & Vent
Water Piping
Gas Pipinq
Roof Drain
Tub/Shower Test
Rouqh Water Heater t/s/re w/43
POOL/SPA
Ptrap/Drain Line
Main Drain/Pool Pipinq
Fill Line/Back Flow
Pool HeateriGas Line
Miscellaneous
Gas Service
Water Service
Lawn Sprinkler
Sanitary Sewer/Cap
Back Flow Device
Rough Plumbing
FinalGas Test
Meter Release
FINAL q/g/rq 84" /23
Notes, Remarks, Etc.
Licffi Cbs:-Licmc Numbq: -
Drtc _ Contnclot
CONSTRUCTION LENDING ACENCY
I hocby affim undo pcnalty of pcrjury thal th6c is a conslruction loding agocy for thc perfomancc of thc work for r.hich this pqmit is
issued (Sa. 3097. Civ. C.).
Lcnda's Namc:
-